超声内镜引导胰管引流术的适应证分层与临床策略述评
Review of indication stratification and clinical strategies for endoscopic ultrasound-guided pancreatic duct drainage
摘要
Abstract
Endoscopic ultrasound-guided pancreatic duct drainage(EUS-PD/EUS-PDD)represents a major advancement in therapeutic endoscopy for pancreatic duct disorders.It is primarily indicated for patients with symptomatic pancreatic duct obstruction in whom endoscopic retrograde pancreatography(ERCP)has failed or is not feasible.The procedure involves transmural puncture of the main pancreatic duct via the stomach,duodenum,or postsurgical jejunal limb,followed by guidewire placement,tract dilation,and stent insertion to achieve ductal decompression and restoration of pancreatic juice drainage.Systematic reviews and meta-analyses have reported an overall technical success rate of 84.8%,a clinical success rate of 89.2%,and an overall adverse event rate of 18.1%,indicating substantial efficacy with non-negligible risks.The common indications for EUS-PD include pancreatic duct disruption due to pancreatic trauma,pancreatic duct injury associated with pancreatic surgery,pancreatic duct disruption secondary to severe acute pancreatitis,and surgically altered anatomy.Complications mainly include post-procedural pancreatitis,bleeding,perforation,and stent-related dysfunction.This review constructs an evidence chain covering indication stratification,procedural approaches,key techniques,complication management,long-term follow-up,and reintervention strategies,aiming to provide a reproducible clinical decision-making framework for the implementation of EUS-PD in endoscopic centers in China.关键词
超声内镜/胰管引流术/慢性胰腺炎/术后解剖改变/会师技术Key words
endoscopic ultrasound/pancreatic duct drainage/chronic pancreatitis/surgically altered anatomy/endoscopic ultrasound-guided rendezvous分类
医药卫生引用本文复制引用
常雨欣,李百文,倪建波..超声内镜引导胰管引流术的适应证分层与临床策略述评[J].上海交通大学学报（医学版）,2026,46(7):847-856,10.基金项目
上海市科学技术委员会"科技创新行动计划"医学创新研究专项项目(23Y11902000) （23Y11902000）
上海申康医院发展中心第二轮促进市级医院临床技能与临床创新三年行动计划(2023-2025年)临床研究数据共享和模拟RCT项目(SHDC2024CRI049) （2023-2025年）
上海交通大学医学院"双百人"项目(20240813) （20240813）
上海交通大学"交大之星"计划医工交叉研究基金(智能医疗健康研究)(YG2023QNB17). Science and Technology Innovation Action Plan of Shanghai Municipal Science and Technology Commission(23Y11902000) （智能医疗健康研究）
Shanghai Hospital Development Center,the Second Round of the Three-Year Action Plan(2023-2025)for Promoting Clinical Skills and Clinical Innovation in Municipal Hospitals Clinical Research Data Sharing and Simulated RCT Project(SHDC2024CRI049) （2023-2025）
"Two-hundred Talents"Program of Shanghai Jiao Tong University School of Medicine(20240813) （20240813）
Fundamental Research Funds for Central Universities(YG2023QNB17). （YG2023QNB17）
